Affordable Care Act (ACA) Information and Open Forum St. Norbert College Health and Wellness Services AND Student Government Association March 27, 2014

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Affordable Care Act (ACA) and Student Health Insurance The ACA was signed into law by President Obama on March 23, 2010 The ACA mandates all United States citizens have health insurance by March 31, 2014

Affordable Care Act (ACA) and Student Health Insurance Everyone now has an insurance requirement Penalties for not having insurance in 2014 are small 1% of yearly household income $95 per person for the first year (maximum penalty per family using this method is $285) $295-$625 over next years Going without insurance is never a good idea, even though the penalty is small the consequences could be great.

Affordable Care Act (ACA) and Student Health Insurance No exclusions because of pre-existing condition Minimum essential benefits must include at least the following: No cap on lifetime benefits No annual cap on benefits – for example mental health, substance abuse disorder services, and behavioral health treatment (including counseling and psychotherapy) In-network preventive care with no out of pocket cost to student

Why Should I Care? Health Insurance is costly, but health care is more costly The ACA guarantees prevention services at no additional costs Knowing your options for insurance and how to use insurance empowers students to take charge of their health care Graduating students will need to know how assess employer benefits and how to access health insurance

Affordable Care Act (ACA) and Student Health Insurance Students have three options: 1. Coverage under a parents plan (until age 26) a. Experts project the cost of most employer plans will increase b. Parental plans may have more out-of-network constraints and access to care may be diminished c. Employers may charge more to have students on the parent plans

Affordable Care Act (ACA) and Student Insurance Options 2. Purchase an individual plan the exchange Bronze, Silver, Gold, Platinum a. Open site and select State b. Determine if eligible for government premium subsidy: based upon family income if the student is claimed as a dependent on their parents tax return 3. Participate in the SNC (WAICU) Student Health Insurance Program

Affordable Care Act (ACA) and Student Health Insurance (Handout) Platinum $0 deductible, 90% co-insurance (student pays 10%) with an out-of-pocket (OOP) maximum of $6,350 then 100% coverage Prescription drug coverage of 10/35/60/25% to $500 Three free in-network physician visits – no OOP Coverage for all essential benefits No out-of-pocket costs for preventive health services No out-of-pocket costs for student health center services

Affordable Care Act (ACA) and Student Health Insurance Gold $0 deductible, 70% co-insurance (student pays 30%) with out-of-pocket (OOP) maximum of $6,350 then 100% coverage Prescription drug coverage of 10/35/60/25% to $500 Three free in-network physician visits – no out-of-pocket costs Coverage for all essential benefits No out-of-pocket costs for preventive health services No out-of-pocket costs for student health center services

Affordable Care Act (ACA) and Student Health Insurance Catastrophic $6,350 deductible, 100% co-insurance(student pays 100%) with out-of-pocket (OOP) maximum of $6,350 then 100% coverage Prescription drug coverage of 10/35/60/25% to $500 Nine free in-network physician visits (no OPP) – split into three free Primary Care Physician (PCP), three free Chiropractic, three free behavioral health Coverage for all essential benefits No out-of-pocket costs for preventive health services No out-of-pocket costs for student health center services

Affordable Care Act (ACA) and Student Health Insurance All three options include free (no OPP) in-network preventive care benefits – see handout All three options have no pre-existing condition exclusion All three options meet minimum essential benefits requirements All three options include services provided at the student health center No deductible, no co-payment, no co-insurance, no cost pre-packaged medications, no OPP

Affordable Care Act (ACA) and Student Health Insurance Annual Premiums: Age Platinum $10 drug$2,617$4,121 Gold $10 drug$2,382$3,752 Cat. $10 drug$1,302$2,050